增强CT及MRI检查在胰腺癌术前TNM分期中的应用

Application of Contrast-enhanced CT and MRI in Preoperative TNM Staging of Pancreatic Cancer

目的 探讨增强CT及MRI检查在胰腺癌术前TNM分期中的临床应用价值。方法 回顾性分析昆明医科大学第一附属医院2019年1月至2021年12月经手术病理确诊的胰腺癌患者62例,分析患者术前的增强CT及MRI图像、手术情况及术后病理结果。由2名高年资放射科医师采用双盲法对患者术前影像图像进行分期,将2种检查方法的术前TNM分期与手术病理结果进行比较。结果 增强CT和MRI检查对胰腺癌术前TNM分期判断的准确率分别为:T分期86.96%(40/46)和89.13%(41/46)、N分期78.57%(33/42)和73.81%(31/42)、M分期96.77%(60/62)和98.39%(61/62),2种检查方法与手术病理结果比较T分期具有较强的一致性、N分期具有中等强度一致性、M分期具有强一致性,且2种检查方法评估的准确性差异无统计学意义(P> 0.05)。结论 增强CT及MRI检查对胰腺癌术前TNM分期评估与手术病理结果对照具有良好的相关性,可为临床医师提供术前评估参考及指导治疗决策,具有良好的临床应用价值。

Objective To investigate the clinical value of contrast-enhanced CT and MRI in preoperative TNM staging of pancreatic cancer.Methods A retrospective analysis was performed on 62 pancreatic cancer patients diagnosed by surgical pathology from January 2019 to December 2021 in the First Affiliated Hospital of Kunming Medical University.The preoperative enhanced CT and MRI images,operation status and postoperative pathological results were analyzed.All the findings were reviewed by two senior radiologists separately for preoperative imaging staging.The preoperative TNM staging of the two methods were compared with the surgical and pathological results.Results The overall accuracy of contrast-enhanced CT and MRI in TNM staging of pancreatic cancer were 86.96%(40/46)and 89.13%(41/46)in T stages,78.57%(33/42)and 73.81%(31/42)in N stages,96.77%(60/62)and 98.39%(61/62)in M stages,both had good consistency in T stages,moderate consistency in N stages and strong consistency in M stages compared with surgical and pathological results.There was no significant difference between the two methods in the accuracy of preoperative TNM staging(P>0.05).Conclusion Enhanced CT and MRI have a good correlation between preoperative TNM staging evaluation and surgical pathological results of pancreatic cancer,which can provide a reference for preoperative evaluation and guide treatment decision making for clinicians,and have good clinical application value.